UC Health: 'We don't want to put patients in the middle'

Apr. 5, 2013

“We care about our patients and certainly don’t want them to have to endure the stress of having to interrupt a life-saving treatment or change their physician,” said Diana Lara, a spokeswoman for UC Health. / Provided

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UC Health says it has agreed not to charge patients insured by Anthem Blue Cross and Blue Shield higher, out-of-network costs even if the hospital system and insurer don’t strike an agreement on reimbursement rates by an April 15th deadline.

“Progress is being made,” said Diana Lara, a spokeswoman for UC Health. “We don’t want to put patients in the middle. We care about our patients and certainly don’t want them to have to endure the stress of having to interrupt a life-saving treatment or change their physician.”

Lara said as along as negotiations are under way between UC and Anthem, the hospital has agreed to “waive out-of-network” costs that otherwise would be charged to Anthem’s roughly 550,000 members should they seek care at UC. Anthem has said only about 14,000 of its members visited a UC Health physician or facility last year.

Last month the two sides agreed to reimbursement rates that UC Health’s hospitals receive from the insurer. Now, the two sides are trying to strike a deal on reimbursement rates for its nearly 700 physicians.

“It comes out to less than $1 per Anthem member,” Lara said.

Anthem could not be reached immediately for Friday.

The contract dispute went public last month when both firms sent letters to Anthem members who received services at UC Health in the last year, informing them that a deal had yet to be reached. UC Health says it needs a “modest” increase on its reimbursement rates for its physicians, to cover costs for staff and services.

Anthem Blue Cross and Blue Shield, the region’s biggest health insurer, argues that UC Health is already the highest paid provider in the region. UC Health denies that claim, and it has third-party data showing that Anthem pays its doctors 20 percent less than it pays those practicing at other academic medical centers such as Ohio State, Indiana University and the University of Kentucky.

The contract wrangling isn’t a new phenomenon.

In 2010, Anthem and UC were part of a similar standoff. At the time, UC Health was a part of the Health Alliance, which included Jewish and Fort Hamilton hospitals, West Chester Hospital and the Drake Center, among others. The Alliance blamed Anthem for trying to cut reimbursements by 3 percent.

Ultimately, a deal was struck two days after the original contract expired.